Department of Health Care, Artesis University College of Antwerp, Belgium.
Gait Posture. 2012 Feb;35(2):231-7. doi: 10.1016/j.gaitpost.2011.09.012. Epub 2011 Oct 2.
Gait efficiency in children with cerebral palsy is usually quantified by metabolic energy expenditure. Mechanical energy estimations, however, can be a valuable supplement as they can be assessed during gait analysis and plotted over the gait cycle, thus revealing information on timing and sources of increases in energy expenditure. Unfortunately, little information on validity and sensitivity exists. Three mechanical estimation approaches: (1) centre of mass (CoM) approach, (2) sum of segmental energies (SSE) approach and (3) integrated joint power approach, were validated against oxygen consumption and each other. Sensitivity was assessed in typical gait and in children with diplegia. CoM approach underestimated total energy expenditure and showed poor sensitivity. SSE approach overestimated energy expenditure and showed acceptable sensitivity. Validity and sensitivity were best in the integrated joint power approach. This method is therefore preferred for mechanical energy estimation in children with diplegia. However, mechanical energy should supplement, not replace metabolic energy, as total energy expended is not captured in any mechanical approach.
脑瘫儿童的步态效率通常通过代谢能量消耗来量化。然而，机械能估计可以作为有价值的补充，因为它们可以在步态分析期间进行评估，并绘制在步态周期上，从而揭示能量消耗增加的时间和来源的信息。不幸的是，关于有效性和敏感性的信息很少。三种机械估计方法：（1）质心（CoM）方法，（2）分段能量总和（SSE）方法和（3）关节功率积分方法，已针对耗氧量和彼此进行了验证。在典型步态和双瘫儿童中评估了敏感性。CoM 方法低估了总能量消耗，敏感性差。SSE 方法高估了能量消耗，敏感性可接受。关节功率积分方法的有效性和敏感性最好。因此，该方法更适合双瘫儿童的机械能估计。然而，机械能量应该补充，而不是替代代谢能量，因为任何机械方法都无法捕获总能量消耗。
